儿童感染新型冠状病毒后第3周行日间手术的可行性

Feasibility of undergoing day surgery at 3rd week after infection with SARS-CoV-2 in children

目的回顾性分析儿童感染新型冠状病毒后第3周行日间手术的可行性。方法收集2022年11月1日至2023年2月28日行日间手术患儿的临床资料,手术时间≤1 h,ASA分级Ⅰ或Ⅱ级,性别不限,年龄≤14岁,BMI 10~30 kg/m^(2)。根据是否感染过新型冠状病毒将患儿分为新冠组和对照组,主要结局指标为患儿术后30 d内呼吸系统相关并发症发生率。次要结局指标包括患儿术后30 d内非计划通气、延迟出院和二次入院率,患儿术前肌酸激酶同工酶(CK-MB)、AST、ALT、Hb、白细胞计数、CRP水平、口咽黏膜炎症分级、手术时间、苏醒时间、术中呼吸抑制、喉痉挛、低氧血症、低血压、窦性心动过缓发生率和追加抢救药物率。结果新冠组337例,对照组1396例。与对照组比较,新冠组患儿术前CK-MB浓度升高,Hb浓度降低(P<0.05)。2组患儿术后30 d内呼吸系统相关并发症发生率、非计划通气、延迟出院和术后二次入院率、术前AST、ALT浓度、白细胞计数、CRP浓度、口咽黏膜炎症分级、手术时间、术中呼吸抑制、喉痉挛、低氧血症、低血压、窦性心动过缓发生率、追加抢救药物率及苏醒时间比较差异无统计学意义(P>0.05)。结论儿童在感染新型冠状病毒后第3周行日间手术的可行性良好。

Objective To retrospectively analyze the feasibility of undergoing day surgery at 3rd week after infection with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in children.Methods The clinical data from children who underwent day surgery from November 1,2022 to February 28,2023,with operation time≤1 h,of American Society of Anesthesiologists Physical Status classificationⅠorⅡ,regardless of gender,aged≤14 yr,with body mass index of 10-30 kg/m^(2),were divided into SARS-CoV-2 group and control group according to whether the children had been infected with the SARS-CoV-2.The main outcome measure was the incidence of respiratory system-related complications within 30 days after surgery.Secondary outcome measures included the rate of unplanned ventilation,delayed discharge and secondary admission within 30 days after surgery.Preoperative creatine kinase isoenzyme(CK-MB),aspartate aminotransferase(AST),alanine aminotransferase(ALT),hemoglobin(Hb),white blood cell count,C-reactive protein(CRP)level,grade of oropharyngeal mucosa inflammation,operation time,emergence time,intraoperative respiratory depression,laryngeal spasm,hypoxemia,hypotension,incidence of sinus bradycardia and rate of additional rescue drugs were recorded.Results There were 337 cases in SARS-CoV-2 group and 1396 cases in control group.Compared with control group,CK-MB concentrations were significantly increased,and the Hb concentration was decreased before surgery in SARS-CoV-2 group(P<0.05).There were no statistically significant differences in the incidence of respiratory system-related complications,unplanned ventilation,delayed discharge and rate of postoperative secondary admission,preoperative AST and ALT concentrations,white blood cell count,CRP concentrations,grade of oropharyngeal mucosa inflammation,operation time,intraoperative respiratory depression,laryngeal spasm,hypoxemia,hypotension,incidence of sinus bradycardia,rate of additional rescue drugs and emergence time between the two groups(P>0.05).Conclusions Feasibility of undergoing day surgery is good at the third week after being infected with the SARS-CoV-2 in children.